Child Health Research Centre - University of Queensland

Our goal is to improve the lives of children with an acquired brain injury by using child-friendly brain imaging methods and developing new therapies and treatments. Our KidStim lab is an advanced brain investigation and treatment facility in CHRC investigating the use non-invasive brain stimulation techniques to improve outcomes in children with neurological impairment.

Participate in a research project

Professor Karen Barlow

Chair in Paediatric Rehabilitation & Conjoint Chair in Paediatric Rehabilitation

Child Health Research Centre
Affiliate Associate Professor

School of Biomedical Sciences
Ms Laura Gascoigne-Pees

Coordinator, Clinical Research/Trials & Casual Research Assistant

Child Health Research Centre
Athena Stein

PhD student

Child Health Research Centre

Recovery from a brain injury is difficult. Imagine how much more difficult it is in childhood. At a time when so much learning, psychological and physical developments is occurring, a child with a brain injury is faced with relearning old skills as well as trying to learn new things and keep up with his or her friends at school. A brain injury can occur because of accidents, concussion, infection, brain tumours, stroke and other causes.

Our Concussion Recovery website offers help and information for families and clinicians about the care of children and adolescents with Concussion.

Visit the Concussion Recovery website

Our research program has a specific focus on recovery from traumatic brain injury and concussion. By increasing our understanding of brain recovery we can improve treatments and rehabilitation therapies.

Mild traumatic brain injury can be loss of consciousness and/or confusion and disorientation shorter than 30 minutes. Symptoms can also include headaches, fuzziness, dizziness, fatigue, and forgetfulness.

Paediatric concussion is a significant public health burden, sometimes referred to as a “silent epidemic”. It affects 1 in 30 children and adolescents before the age of 18 years. Children with concussion often report post concussive symptoms (PCS):

Headaches
Dizziness
Mood disturbance
Concentration difficulties that can impact learning
Sleep disturbance

Post concussive symptoms are most severe immediately and soon after the incident but it can persist for weeks to months. Most recover easily, however, 15-25% of children with concussion have symptoms that last over a month with a significant impact on their school performance, friendships and family life. Understanding why some children recover quickly and other takes several months can help pave the way for new advances in treatment and rehabilitation therapies.

Learn more about our current research or email uq_abic@uq.edu.au.

The KidStim lab is the first lab in Australia to explore non-invasive brain stimulation (NIBS) in children with brain injury. It opens up an exciting new chapter in treatments for children with persistent problems after a brain injury, as well as children with mood and behavioural problems. NIBS can be used to investigate and treat persistent symptoms following a concussion:

Traumatic Brain Injury
Stroke
Depression and mood problems
Anxiety
Autism

What is Non-invasive Brain Stimulation?

According to the International Neuromodulation Society, neuromodulation is technology that acts directly upon nerves. It is the alteration—or modulation—of nerve activity to produce natural biological responses by delivering electrical or pharmaceutical agents (drugs) directly to a target area.

The KidStim lab has state-of-the-art equipment to help us understand brain recovery after an injury including:

Transcranial Magnetic Stimulation (TMS ) - A non-invasive procedure that uses magnets held on the outside of the head to stimulate nerve cells in the brain
Repetitive Transcranial Magnetic Stimulation (rTMS) - Used to alter the responsiveness of groups of neurons in the brain. For example, it can be used to improve function in stroke and help depression
Theta Burst Stimulation (TBS) - Similar to rTMS, TBS is being explored as a faster and easier option to rTMS
Neuronavigation - Helps us to accurately track brain function back to your MRI. It helps the accurate placement of the TMS magnets to stimulate specific brain regions
Transcranial direct current stimulation (tDCS) - A new technology showing promise in rehabilitation: it delivers low levels of current to improve brain function
High-Density Electroencephalography (HD EEG) - Provides high resolution pictures and connectivity maps of brain activity
Functional Near-Infrared Spectroscopy (fNIRS) - Using light to show changes in brain blood oxygenation during activities, fNIRS may be useful to track response to treatments

The KidStim Lab will be using Transcranial Magnetic Stimulation (TMS) equipment to measure activity and function of specific brain circuits. It uses brief magnetic pulses to stimulate nerve cells and change function in a selected part of the brain. The MRI-strength magnetic field is delivered from a coil placed over the scalp and a changing magnetic field is used to cause electric current to flow via electromagnetic induction. The KidStim laboratory will also be utilising neuronavigation equipment. This technology acts like a GPS system to guide or "navigate” areas of the brain so that we can accurately target TMS treatment.

To learn more about upcoming studies in the KidStim lab or if you are interested in conducting research in the KidStim laboratory or would like to learn more about collaborating on research, please contact uq_abic@uq.edu.au.

The ABiC group is in the planning phase of cutting edge research, supported through recently awarded grants.

Expression of interest: Consumer advisory group for the development of Australian and New Zealand Clinical Practice Guidelines (CPG) for mild traumatic brain injury (mTBI)

An mTBI, caused by a bump, blow, or jolt to the head, or hit to the body that causes the head and brain to move quickly back and forth, can result in significant long-term symptoms and loss of function. Patient care along the journey from injury to recovery, however, is highly variable and can lead to poor outcomes.

Dr Karen Barlow, along with a team of renowned doctors, healthcare professionals and researchers across Australia and New Zealand received a grant from the National Health and Medical Research Council (NHMRC) to develop the clinical practice guidelines for mild traumatic brain injury. Clinical practice guidelines (CPG) are recommendations for clinicians about the care of patients with specific conditions and are based upon the best available research evidence and practice. Clinical Practice Guidelines improve outcomes for patients but there are few CPGs which guide mTBI management from injury to recovery and none that have been adapted for use across the Australian/New Zealand healthcare system. We hope to deliver this with the development of this CPG.

The success of the guidelines is not only through the expertise of the doctors and researchers involved in its development but from the patients and families who will help shape care to meet their needs.

Your involvement

We are looking for 10 consumers from the TBI community to form the consumer advisory group for consultation and surveys regarding the CPG and supporting tools. Participants would attend and be reimbursed for 4 online meetings, each lasting up to 2 hours, as well as 4 hours per meeting for pre and follow-up activities (24 hours in total).
We are also looking for 8 consumers from the mTBI community to form the Aboriginal and Torres Strait Islander peoples working group for consultation and surveys regarding the CPG and supporting tools. This group will be supported and coordinated by an Aboriginal and Torres Strait Islander people representative, who is a healthcare professional. Participants would attend and be reimbursed for 4 online meetings, each lasting up to 2 hours, as well as 4 hours per meeting for pre and follow-up activities (24 hours in total).

This project is due to complete around Feb 2024 with the publishing of these guidelines for use. The time commitment would be over a period of approximately 12-18 months.

If you are interested in participating, please complete the participation form (PDF, 191.9 KB) and return it to uq_abic@uq.edu.au.

Clinical trial for children, adolescents and young adults with concussion

This study is investigating repetitive Transcranial Magnetic Stimulation (rTMS) as potential treatment for children, adolescents and young adults with persistent post-concussion symptom.

Participants will be randomised to receive either 10 rTMS treatment or sham treatment (placebo/dummy) over 2 weeks, with the option to receive a further two weeks of 10 rTMS treatment sessions.

Study assessments include advanced brain imaging and activity measurements such as magnetic resonance imaging (MRI) and electroencephalography (EEG), as well as questionnaires to assess well-being and changes in symptoms.

The study will take place in the KidStim Lab at the Centre for Children’s Health Research.

Who is eligible to participate?

Children, adolescents and young adults aged 11-25 years with a diagnosis of post-concussion syndrome.
Have two or more symptoms persisting for at least two months.
Children who do not have epilepsy or other seizure disorders.

To learn more about the study or to see if you/your child is eligible, please contact Jacob Thorstensen on 07 3069 7344 or UQ_ABiC@uq.edu.au.

Download the flyer

Health service utilisation after childhood acquired brain injury

This study is investigating what health care services are used by families with a child who has had an acquired brain injury (ABI) in Queensland. This will help us identify gaps in care and the cost associated with ABI, which could help the government and supporting agencies plan for the future. The study involves the two telephone interviews consisting of some surveys that investigate functional independence, behaviour, quality of life, health service access and strengths and difficulties associated with an ABI. Participants will be asked to fill in some surveys online. The total time of involvement is approximately 2-3 hours.

The study will take place at the Centre for Children’s Health Research.

Who is eligible to participate?

Children/families of children who received care from the Queensland Paediatric Rehabilitation Service (QPRS) for acquired brain injury, including the Queensland Children’s Hospital (QCH).
An ABI diagnosis at QCH from 2014 onwards.
Children under the age of 18 years with an ABI.

To learn more about the study or to see if you/your child is eligible, please contact Jonathan Ho on:

Phone: 07 3069 7597
Email: UQ_ABiC@uq.edu.au

Download the flyer

Can non-invasive brain stimulation improve attention in children with acquired brain injury?

Poor attention is one of the most commonly reported problems after an acquired brain injury (ABI). This study aims to investigate whether transcranial direct current stimulation (tDCS; a type of non-invasive brain stimulation) can improve attention in children following an acquired brain injury.

We are aiming to recruit both children with an ABI and healthy control children (without ABI). Participants will receive three sessions of tDCS over the course of approximately 2-3 weeks. Prior to tDCS, participants will also complete some clinical assessments, including EEG, and health and quality of life questionnaires. Participants can also opt in to have an MRI. Before, during and after tDCS, participants will complete some attention games on a computer.

The study will take place at the KidStim Lab at the Centre for Children’s Health Research (South Brisbane).

Who is eligible to participate?

Children and adolescents aged between 8-17 years (inclusive)
Have previously had a concussion or other acquired brain injury (mild to severe) OR
No previous history of concussion or other brain injury (healthy controls)
Can attend 3 x one-hour sessions and complete study assessments (total 7-8 hours commitment over 2-3 weeks)

To learn more about the study or to see if your child is eligible, please contact Athena Stein on 07 3069 7555 or a.stein@uq.edu.au

Download flyer

Assessment of brain connectivity after acquired brain injury

After a brain injury, the communication between different regions of the brain (often called brain connectivity) can either slow down or fail.

This study is investigating brain connectivity in children, adolescents and young adults recovering from an acquired brain injury (ABI).

Participants who do not have a brain injury will also be assessed to provide a comparison.

What is involved?

Participants with a brain injury will be assessed using three different and safe methods:

Magnetic Resonance Imaging (MRI)
Electroencephalography (EEG)
Functional near infrared spectroscopy (fNIRS)

Participants who do not have a brain injury will be assessed using EEG and fNRIS.

All participants will have their attention, memory, problem solving skills and quality of life using guided questionnaires.

This study will take place at the Centre for Children’s Health Research in South Brisbane.

The MRI procedure will be conducted at the Herston Imaging Research Facility.

All assessments and procedures will be completed in a 1-day visit.

Who is eligible to participate?

Participants with a brain injury:

Children, adolescents and young adults aged 8-18 years who received a diagnosis of ABI at least 12 months ago
Do not have epilepsy or seizure disorders
Have no history of significant medical or psychiatric disorders before injury (excluding ADHD)

Participants who do not have a brain injury:

Children, adolescents and young adults aged 8-18 years

To learn more about the study or to see if you/your child is eligible, please contact Jacob Thorstensen T: 07 3069 7344 E: UQ_ABiC@uq.edu.au

Download flyer

Improving memory with brain stimulation after childhood acquired brain injury

This study is investigating the use of transcranial Direct Current Stimulation (tDCS) during an afternoon nap, to improve memory in children with an Acquired Brain Injury (TBI).

A group of healthy children will also receive tDCS in the same manner for comparison.

Study measures include brain activity and functional assessments such as electroencephalography (EEG) and memory tests.

Participants will be randomised to receive either active tDCS stimulation or sham (placebo) stimulation in a one-time session, while they take a short nap. This will take place at the Centre for Children’s Health Research and is expected to take 2-3 hours.

Who is eligible to participate?

Children and adolescents aged 6-18 years who have had a acquired brain injury at least 12-months ago
Children and adolescents aged 6-18 years who are considered healthy

To learn more about the study or see if you/your child is eligible, please contact Jacob Thorstensen on UQ_Abic@uq.edu.au.

Download flyer

Student projects

Whether you are a student in pre-med, health sciences, engineering, psychology, or SBMS, we have a variety of fascinating projects that students like you can take part in. These include Honours projects, and UQ winter and summer studentships. Current projects involving children and young adults with brain injury include:

Use of transcranial electrical stimulation to improve cognitive outcomes
The influence of sleep on recovery
Fatigue following brain injury
Functional near infrared spectroscopy and High density EEG to explore brain connectivity
Multiple projects in acquired brain injury

Browse all publications by Professor Karen Barlow.

Selected publications

Unravelling the Link Between Brain Network Connectivity and Cognitive Attention Following Acquired Brain Injury: A Systematic Review of Structural and Functional Measures

This systematic review concisely and meaningfully synthesizes a large heterogenous body of research relating to the association between attention and brain connectivity to identify clear trends in traumatic brain injury (TBI) and stroke. The review found greater structural and functional connectivity within and between executive, salience, and default mode networks (DMNs) is related to greater attention after TBI, and greater functional connectivity between DMN and other task-positive networks is associated with greater attention after TBI. Lower structural connectivity within executive control network (ECN) is associated with lower attention after stroke, and greater functional connectivity within the dorsal attention network (DAN) is associated with greater attention after stroke.

Evidence of Ongoing Cerebral Microstructural Reorganization in Children With Persisting Symptoms Following Mild Traumatic Brain Injury

Following mTBI, free water accumulation occurs in white matter tracts. This study examines neurite orientation dispersion and density imaging (NODD metrics including orientation dispersion index (ODI) and fraction of isolated free water (FISO) longitudinally following mTBI in children. These metrics may allow a more advanced insight into microstructural damage following pediatric mTBI and potentially predict recovery or persistence of post-concussion symptoms.

Changes in working memory-related cortical responses following pediatric mild traumatic brain injury: A longitudinal fMRI study

Persistent post-concussion symptoms (PPCS) lasting longer than 4 weeks affect 25% of children with mild traumatic brain injury (mTBI) or concussion. Working memory (WM) problems are a common complaint in children with PPCS. Despite normal function on traditional neuropsychological tests, these children exhibit aberrant cortical responses within the dorsolateral prefrontal cortex (dlPFC) and default mode network (DMN) regions – both of which are implicated in WM. Using a prospective, longitudinal cohort study design, we investigated changes in cortical fMRI responses within the dlPFC and DMN during an nback WM task at two timepoints: one and two months post-injury.

Efficacy of Melatonin for Sleep Disturbance in Children with Persistent Post-Concussion Symptoms: Secondary Analysis of a Randomized Controlled Trial

Sleep disturbances are commonly reported in children with persistent post-concussion symptoms (PPCS). Melatonin treatment is often recommended, yet supporting evidence is scarce. We aimed to evaluate the efficacy of treatment with melatonin for sleep disturbance in youth with PPCS following mild traumatic brain injury (mTBI).

Relating brain connectivity with persistent symptoms in pediatric concussion

Persistent post-concussion symptoms (PCS) have a detrimental effect on quality of life and neurodevelopment in children. Targeted therapies to resolve these symptoms are scarce and the link between brain activity, PCS and affected behaviors are relatively unknown. In this study, Iyer et al. reveals the association between brain connectivity and key symptoms and behaviors, such as poor sleep and cognition.

Longitudinal Assessment of Cortical Excitability in Children and Adolescents With Mild Traumatic Brain Injury and Persistent Post-concussive Symptoms

Symptoms following a mild traumatic brain injury (mTBI) usually resolve quickly but may persist past 3 months in up to 15% of children. Mechanisms of mTBI recovery are poorly understood, but may involve alterations in cortical neurophysiology. Transcranial Magnetic Stimulation (TMS) can non-invasively investigate such mechanisms, but the time course of neurophysiological changes in mTBI are unknown.

Unlocking the key to treating children with brain injuries by using imaging to predict how long, and if a child will fully recover after a head knock

Aired on 7 December 2023

Professor Barlow discusses the need for clear guidelines across Australia on how patients with persistent concussion symptoms should be managed, with access to treatment services and multidisciplinary clinics in this ABC News article.
Our HD-EEG appeared in the CHF Impact report.
We recently received an MRFF grant for: Australian Clinical Practice Guidelines for the Assessment and Management of Mild Traumatic Brain Injury and Post-Concussion Symptoms. View details.
Athena Stein has been awarded the internationally recognised Fellowship of the Higher Education Academy (FHEA) for her commitment to professionalism in teaching and learning in higher education
Athena Stein, PhD student in ABiC, was accepted into the Wonder of Science Young Science Ambassador program, hosted by UQ. As a Young Science Ambassador, Athena will undertake at least five trips of her choice throughout the year to schools around QLD.
Professor Karen Barlow and Dr Karik Iyer won the EBIC People's Choice award for their poster titled Investigating brain connectivity and sleep changes following melatonin treatment in children with persistent post-concussion symptoms
Melatonin linked to improved brain function in child concussion: Melatonin could improve brain functions related to sleep quality in children recovering from concussion, according to a University of Queensland study.
Concussion in children: Short of wrapping our kids in cotton wool, it’s hard to avoid the bumps and bruises of childhood. But sometimes, a fall at home or a head knock in sport should not be underestimated. Associate Professor Karen Barlow discusses the signs and symptoms of concussion in children, possible treatments, and the road to recovery in this blog article.
The Queensland Motor Accident Insurance Commission (MAIC) research funding awarded April 2019: Randomised controlled clinical trial investigating rTMS in children with persistent post-concussion syndrome (see "Our research projects" heading for more details)
The Queensland Motor Accident Insurance Commission (MAIC) research funding received April 2019: Healthcare utilisation after childhood traumatic brain injury in Queensland
Research grant awarded by Foundation for Children: Caring for Children after a Concussion: Uptake, Outcomes, and Health Care Impacts of a Patient-Driven Technology-Assisted Clinical Care Pathway.
KidStim Lab launch: Australia’s first laboratory dedicated to improving outcomes for children with brain injuries.
Dr Kartik Iyer has received an award from the Brain Foundation: Assessing Brain Based Recovery In Children With Concussion Following Brain Stimulation
Research grant awarded by the Ian Potter foundation: ‘Lighting the way to recovery after brain injury in children using functional near infrared technology’

Acquired Brain Injury in Children (ABiC)

Professor Karen Barlow

Ms Laura Gascoigne-Pees

Athena Stein

What is Non-invasive Brain Stimulation?

Expression of interest: Consumer advisory group for the development of Australian and New Zealand Clinical Practice Guidelines (CPG) for mild traumatic brain injury (mTBI)

Clinical trial for children, adolescents and young adults with concussion

Health service utilisation after childhood acquired brain injury

Can non-invasive brain stimulation improve attention in children with acquired brain injury?

Assessment of brain connectivity after acquired brain injury

Improving memory with brain stimulation after childhood acquired brain injury

Student projects

Selected publications

Unlocking the key to treating children with brain injuries by using imaging to predict how long, and if a child will fully recover after a head knock